Provider Demographics
NPI:1023801768
Name:HEALTHCARE LLC.
Entity type:Organization
Organization Name:HEALTHCARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LNHA
Authorized Official - Prefix:
Authorized Official - First Name:DEWO
Authorized Official - Middle Name:MEBRAT
Authorized Official - Last Name:YADETO
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:971-429-9813
Mailing Address - Street 1:459 SE 192ND AVE APT 502
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-5997
Mailing Address - Country:US
Mailing Address - Phone:971-429-9813
Mailing Address - Fax:
Practice Address - Street 1:459 SE 192ND AVE APT 502
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-5997
Practice Address - Country:US
Practice Address - Phone:971-429-9813
Practice Address - Fax:971-429-9813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-26
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness